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Local vs. General Anesthetic in TAVR

Shorter transcatheter aortic valve replacement procedure time in local anesthetic group

HealthDay News — For patients undergoing transcatheter aortic valve replacement (TAVR), local anesthetic (LA) is as safe as general anesthetic (GA), with shorter procedure time and number of days in the hospital, according to a study published in the December 1 issue of The American Journal of Cardiology.

Avais Jabbar, MBBS, from the Freeman Hospital in Newcastle Upon Tyne, U.K., and colleagues described their experience in patients undergoing TAVR under LA who were subsequently transferred to a low dependency unit. Overall, 145 patients had the TAVR procedure under GA and 71 under LA.

The researchers found that the procedure time, as measured from time in room to skin closure, was significantly shorter in the LA group (108 versus 143 minutes; P<0.001). Skin open to skin closure time did not differ between the groups (78 versus 79.4 minutes; P=0.57). No differences were seen between the groups in 30-day: aortic regurgitation > mild (P=0.67), need for permanent pacing (P=0.32), and disabling cerebrovascular accidents (P = 1.0). There was no significant difference in 30-day survival (95.9% in GA versus 100% in LA; P=0.17), while the LA group had a significantly shorter number of days in the hospital (two, versus four in the GA group; P<0.001). The LA group had no emergency conversions to GA; only one patient required admission to a high dependency unit.

"In conclusion, performing a TAVR under LA is at least as safe as GA," the authors write.